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The Joint Commission on Accreditation of Healthcare Organizations and the Centers for Medicare and Medicaid Services (CMS) have established the administration of antibiotics within 4 hours as a core measure of quality for inpatients with a discharge diagnosis of community-acquired pneumonia (CAP), regardless of whether the diagnosis was established at admission. Both organizations have based this standard on retrospective data that indicate a small decrease in inpatient and 30-day mortality. Many hospitals have adopted the University HealthSystem Consortium goal of 90% performance on these core measures.
In a retrospective chart review of a random sample of 152 patients who were admitted through a university emergency department (ED) and dis…